Is fat pad pain the same as patellar tendinitis?

Where it hurts

The patellar tendon runs from the lower tip of the kneecap to the bump on the shin. In patellar tendinopathy, often called jumper's knee, tenderness is usually at a small point right at the lower tip of the kneecap. In fat pad impingement, tenderness is softer and deeper, either side of the tendon, and there may be a puffy swelling there.

What makes it worse

• Tendon pain: jumping, landing, deep squats and stairs, especially when loading the bent knee
• Tendon pain: often warms up during activity, then is worse the next morning
• Fat pad pain: standing with the knee locked straight, kicking and hyperextension
• Fat pad pain: often eased by keeping a slight bend in the knee
• Both: can flare after a sudden increase in training

Why the difference matters

Treatment differs. Tendinopathy usually responds to a progressive tendon-loading programme, including heavy, slow strength exercises and a gradual return to jumping. Fat pad impingement responds to avoiding end-range straightening, taping, and strength and control work through a comfortable range. Loading a fat pad problem like a tendon problem, or the reverse, can keep the pain going.

Getting the right diagnosis in Doha

Book an assessment if pain below the kneecap has lasted more than a few weeks or is stopping you from training. At Aman Hospital, Dr. Gelber examines the knee and may use ultrasound or MRI to look at the tendon and fat pad. He will also check for other causes of pain at the front of the knee before agreeing a plan with you and your physiotherapist.